Provider Demographics
NPI:1447256854
Name:TRAHEY, THOMAS FRANCIS III (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:TRAHEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1718 E 4TH ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3261
Mailing Address - Country:US
Mailing Address - Phone:704-343-9800
Mailing Address - Fax:704-347-2011
Practice Address - Street 1:1028 LEE ANN DR NE
Practice Address - Street 2:SUITE 100
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2903
Practice Address - Country:US
Practice Address - Phone:704-316-5353
Practice Address - Fax:704-316-5354
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC30749174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC83707OtherBLUE CROSS BLUE SHIELD
NC893707Medicaid
287188OtherMAMSI
561845661OtherCHAMPUS
9454OtherPARTNERS
NC83707OtherBLUE CROSS BLUE SHIELD
561845661OtherCHAMPUS